Tag: transfusion

Upvote Story 5
Researchers at Massachusetts General Hospital (MGH; Boston, USA), Harvard Medical School (HMS; Boston, MA, USA), and other institutions conducted a trial to see if treating stored packed sheep RBCs with NO before transfusion could prevent PH. To do so, cohort sheep were transfused with autologous RBCs treated with NO and stored for 40 days; control sheep received stored RBCs not exposed to NO. Pulmonary and... Read More | Comment
Upvote Story 10
Hemoglobin is important for cerebral oxygenation and strategies to minimize anemia should be undertaken. Although higher hemoglobin levels are associated with less cerebral ischemia and better clinical outcome, whether this remains true whenever red blood cell transfusion is used to achieve this result remains unclear. Hemoglobin is a key component in oxygen delivery, and thus cerebral oxygenation. Higher hemoglobin levels and red blood cell transfusion... Read More | Comment
Upvote Story 6
In a single centre UK HEMS study, in patients with suspected traumatic hemorrhage who received a PRBC transfusion there was an observed, but non-significant, reduction in mortality at 6 h and 28 days, also reflected in a massive transfusion subgroup. Patients receiving pre-hospital PRBC were significantly less likely to require an in-hospital major transfusion. Further adequately powered multi-centre prospective research is required to establish the optimum strategy... Read More | Comment
Upvote Story 16
A restrictive transfusion threshold is recommended in nearly all critically ill patients. This is at least noninferior to more liberal transfusion practice; in addition, a restrictive threshold has shown improved outcomes in some patients and decreased chances of adverse events in patients. Judicious use of red cells improves patient outcome and protects the blood supply, a limited resource. More data are needed to determine appropriate... Read More | Comment
Upvote Story 4
The Michel–Weinbaum steady-state Starling principle has important consequences for clinical practice. The hope that biophysical intravascular colloid therapy with albumin or plasma substitutes can deliver plasma volume support without causing oedema is in vain. The rational approach is to use isotonic salt solutions to support the ECF volume, while care is taken to avoid harmful capillary hypertension. In current practice, a judicious infusion of norepinephrine... Read More | Comment
Upvote Story 9
Data from the largest registry of critically ill trauma patients receiving extracorporeal life support (ECLS) demonstrates reasonable survival. With growing experience and improved safety profile, trauma should not be considered a contraindication for ECLS. Further analysis of the ELSO registry regarding trauma-specific risk factors and ECLS-specific practices may identify best candidates and improve trauma ECLS outcomes. Two hundred seventy-nine trauma patients were identified (0.92% of... Read More | Comment
Upvote Story 14
This retrospective analysis was conducted in a US Military population across 6 combat hospitals in Iraq and Afghanistan between January 2004 and October 2007. Patient’s transfused at least 1 unit RBCs met inclusion criteria for the study and were divided into 2 groups; those transfused warm fresh whole blood (WFWB), RBCs, and plasma but no aphaeresis platelets (aPLT) and those transfused component therapy (CT) of... Read More | Comment
Upvote Story 6
Early noninvasive ventilation combined with nonroutine transfusion is well tolerated in acute chest syndrome in children and may spare transfusion in some patients. Early recognition of patients still requiring transfusion is essential and warrants further studies. Demographic data, laboratory and radiologic findings, transfusions, invasive ventilation, oxygen and noninvasive ventilation settings, duration of opioid treatment, length of hospital stay, and severe sickle cell disease complications in... Read More | Comment
Upvote Story 10
There is a kind of self-fulfilling prognostic pessimism when it comes to Intracerebral Hemorrhage. And this pessimism sometimes leads to less than optimal care in patients who otherwise might have had a reasonably good outcome if they were managed aggressively. Despite the poor prognosis of these patients overall, there is some evidence to suggest that early aggressive medical management may improve outcomes. As such, the... Read More | Comment
Upvote Story 24
RBC transfusion was independently associated with longer duration of mechanical ventilation in pediatric acute respiratory distress syndrome. Hemoglobin transfusion thresholds should be tested specifically within pediatric acute respiratory distress syndrome to establish whether a more restrictive transfusion strategy would improve outcomes. Of 357 pediatric acute respiratory distress syndrome patients, 155 (43%) received RBC, 82 (23%) received fresh frozen plasma, and 92 (26%) received platelets. Patients... Read More | Comment
Upvote Story 12
We propose that the most promising therapeutic strategies to explore are interleukin-10 therapy, down-modulating C-reactive protein levels, targeting reactive oxygen species, or blocking the interleukin-8 receptors; all focused on the transfused recipient. In the long-run, it may perhaps also be advantageous to explore other strategies aimed at the transfused recipient or aimed toward the blood product, but these will require more validation and confirmation first. Read More | Comment
Upvote Story 11
Risk factors for delirium following cardiac surgery are incompletely understood. The aim of this study was to investigate whether intra-operative pathophysiological alterations and therapeutic interventions influence the risk of post-operative delirium. In patients undergoing cardiac surgery, various intra-operative events, such as transfusion of platelets, were risk factors for the development of a post-operative delirium in the ICU. Further research is needed to unravel the underlying... Read More | Comment
Upvote Story 8
The age of transfused red cells did not affect 90-day mortality among critically ill adults. In an international, multicenter, randomized, double-blind trial, we assigned critically ill adults to receive either the freshest available, compatible, allogeneic red cells (short-term storage group) or standard-issue (oldest available), compatible, allogeneic red cells (long-term storage group). The primary outcome was 90-day mortality. Read More | Comment
Upvote Story 4
The safety of restrictive transfusion strategies likely differs for critically ill patients versus perioperative patients. Further trials investigating transfusion strategies in the perioperative setting are necessary. The primary outcome was 30-day all-cause mortality, sub-grouped by surgical and critical care patients. Secondary outcomes included myocardial infarction, stroke, renal failure, allogeneic blood exposure, and length of stay. Odds ratios and weighted mean differences were calculated using random... Read More | Comment
Upvote Story 12
Physicians with more experience are generally believed to have accumulated knowledge and skills during years in practice and therefore to deliver high-quality care. However, evidence suggests that there is an inverse relationship between the number of years that a physician has been in practice and the quality of care that the physician provides. Physicians who have been in practice longer may be at risk for... Read More | Comment
Upvote Story 4
Although blood transfusion is a lifesaving therapy for some patients, transfusion has been named 1 of the top 5 overused procedures in US hospitals. As unnecessary transfusions only increase risk and cost without providing benefit, improving transfusion practice is an effective way of promoting high-value care. Most high-quality clinical trials supporting a restrictive transfusion strategy have been published in the past 5 to 10 years,... Read More | Comment
Upvote Story 4
Lower thresholds for blood transfusions during cardiac surgery have proven to be safe and provide good patient outcomes compared to traditional thresholds, according to the largest research study ever performed in this area. The lower or “restrictive” threshold also can help reduce the amount of blood transfused and money spent for each procedure. Read More | Comment
Upvote Story 6
Blood transfusions are common in critically ill patients; two in five adults admitted to an ICU receive at least one transfusion during their hospitalization. Recently, there has been growing concern about the potential dangers involved with prolonged blood storage. Several provocative observational and retrospective studies found that prolonged storage time (ie, the age of the blood being transfused) negatively affects clinical outcomes. Read More | Comment
Upvote Story 10
In the first large study to look at how blood transfusions from previously pregnant women affect recipients’ health, researchers discovered men under 50 were 1.5 times more likely to die in the three years following a transfusion if they received a red blood cell transfusion from a woman donor who had ever been pregnant. This amounts to a 2 percent increase in overall mortality each... Read More | Comment